Assessment of range of motion in total knee arthroplasty

  • Research type

    Research Study

  • Full title

    Does pre-operative range of motion affect post-operative range of motion and need for manipulation under anaesthetic in total knee arthroplasty?

  • IRAS ID

    227293

  • Contact name

    Kevin E Wembridge

  • Contact email

    kevin.wembridge@rothgen.nhs.uk

  • Sponsor organisation

    The Rotherham NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 11 months, 31 days

  • Research summary

    The aim of total knee arthoplasty (TKA) (joint replacement) is to improve pain, function and movement in degenerative joints of multiple causes, mostly osteoarthritis. A complication of surgery is stiffness, which may be in flexion (bending) or extension (straightening) and this may affect function and pain. For a cohort of patients with significant stiffness, a second procedure is required to be undertaken – manipulation under anaesthetic(MUA). This requires a further admission, return to theatre, and inpatient stay with CPM (continuous passive motion) machine (a machine which continually moves the knee in order to maintain improved movement). This has a clear associated cost and potential worse outcome for the patient (including risk of complications from inpatient admission and repeat surgery such as infection and deep vein thrombosis).

    We propose to assess range of motion prior to and after TKA at regular and standard intervals, for all patients undergoing primary TKA. We will also collect data relating to previous surgery to the knee, demographic details and medical history of each patient. With this data we aim to assess if we can predict those patients at higher risk for requiring MUA, and as a result instigate more intensive physiotherapy, which may involve early use of CPM after primary surgery, to negate the need for MUA. We will also be able to better inform patients of the risk of requiring MUA, in order to give more informed consent. There is also the potential cost saving of repeat admission and theatre procedure.
    By accurately assessing range of motion pre and post-operatively for a large group of patients, in a single unit, we aim to collect a complete set of data for a large enough groups of patients to assess many factors that may affect range of motion.

  • REC name

    Yorkshire & The Humber - Leeds East Research Ethics Committee

  • REC reference

    17/YH/0145

  • Date of REC Opinion

    10 May 2017

  • REC opinion

    Further Information Favourable Opinion